Cytologic diagnostic approach of pleuropulmonary blastoma: a case report

https://doi.org/10.19106/JMedSci005403202209

Auliya Suluk Brilliant Sumpono(1*), Alva Sinung Anindita(2), Junaedy Yunus(3), Didik Setyo Heriyanto(4)

(1) Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta
(2) Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta
(3) Department of Anatomy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta
(4) Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author

Abstract


Pleuropulmonary blastoma (PPB) is a very rare pediatric lung tumor that arises in the pulmonary parenchyma, mediastinum, and pleura. The tumor has rapid disease progression and therefore the prognosis is remarkably poor. We reported a 4-year-old girl who complained of high fever and shortness of breath for the past 8 weeks. The patient was referred from the previous hospital with a pulmonary mass. CT scan of the chest with contrast showed a solid cystic mass with necrotic areas in the 1st, 2nd, and 3rd segments of the left lung with sized 4.8 x 8.1 x 6.6 cm3. As the tumor mass was inoperable, an ultrasound-guided fine-needle aspiration biopsy (FNAB) was conducted to diagnose the pulmonary lesion. We concluded that the lung tumor was a PPB based on FNAB cytology and immunocytochemistry staining. The histopathology feature of PPB appeared similar to fetal lung tissue. Cytologic features obtained from fine-needle aspiration cytology smears and cell blocks followed by immunocytochemistry assay could provide a proper and accurate diagnosis in an inoperable surgical pathology case.


Keywords


pleuropulmonary blastoma; pediatric tumor; cytology; pulmonary parenchyma; mediastinum

Full Text:

PDF


References

Bisogno G, Sarnacki S, Stachowicz-Stencel T, Minard Colin V, Ferrari A, Godzinski J, et al. Pleuropulmonary blastoma in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations. Pediatr Blood Cancer 2021; 68 Suppl 4:e29045.
https://doi.org/10.1002/pbc.29045
2.Priest JR, Magnuson J, Williams GM, Abromowitch M, Byrd R, Sprinz P, et al. Cerebral metastasis and other central nervous system complications of pleuropulmonary blastoma. Pediatr Blood Cancer 2007; 49(3):266-73.
https://doi.org/10.1002/pbc.20937
3.Boman F, Hill DA, Williams GM, Chauvenet A, Fournet JC, Soglio DBD, et al. Familial association of pleuropulmonary blastoma with cystic nephroma and other renal tumors: a report from the International Pleuropulmonary Blastoma Registry. J Pediatr 2006; 149(6):850-4.
https://doi.org/10.1016/j.jpeds.2006.08.068
4.Pai S, Eng HL, Lee SY, Hsaio CC, Huang WT, Huang SC, et al. Correction: Pleuropulmonary blastoma, not rhabdomyosarcoma in a congenital lung cyst. Pediatr Blood Cancer 2007; 48(3):370-1.
https://doi.org/ 10.1002/pbc.20965
5.Messinger YH, Stewart DR, Priest JR, Williams GM, Harris AK, Schultz KAP, et al. Pleuropulmonary blastoma: a report on 350 central pathology-confirmed pleuropulmonary blastoma cases by the International Pleuropulmonary Blastoma Registry. Cancer 2015; 121(2):276-85.
https://doi.org/10.1002/cncr.29032
6.González IA, Mallinger P, Watson D, Harris AK, Messinger YH, Schultz KAP, et al. Expression of p53 is significantly associated with recurrence-free survival and overall survival in pleuropulmonary blastoma (PPB): a report from the International Pleuropulmonary Blastoma/DICER1 Registry. Mod Pathol 2021; 34(6):1104-15.
https://doi.org/10.1038/s41379-021-00735-8
7.Dehner LP, Messinger YH, Schultz KAP, Williams GM, Wikenheiser-Brokamp K, Hill DA. Pleuropulmonary blastoma: evolution of an entity as an entry into a familial tumor predisposition syndrome. Pediatr Dev Pathol 18(6):504-11.
https://doi.org/10.2350/15-10-1732-OA.1
8.Priest JR, McDermott MB, Bhatia S, Watterson J, Manivel JC, Dehner LP. Pleuropulmonary blastoma: a clinicopathologic study of 50 cases. Cancer 1997; 80(1):147-61.
9.Christosova IR, Avramova BE, Drebov RS, Shivachev HI, Kamenova MA, Bobev DG, et al. Diagnosis and treatment of pleuropulmonary blastoma-single center experience. Pediatr Pulmonol 2015; 50(7):698-703.
https://doi.org/10.1002/ppul.23047
10.Ferrara D, Esposito F, Rossi E, Shangolabad PG, D’Onofrio V, Bifano D, et al. Type II pleuropulmonary blastoma in a 3-years-old female with dyspnea: a case report and review of literature. Radiol Case Rep 2021; 16(9):2736-41.
https://doi.org/10.1016/j.radcr.2021.06.022
11.Orazi C, Inserra A, Schingo PMS, De Sio L, Cutrera R, Boldrini R, et al. Pleuropulmonary blastoma, a distinctive neoplasm of childhood: report of three cases. Pediatr Radiol 2007; 37(4):337-44.
https://doi.org/10.1007/s00247-006-0402-0
12.Geiger J, Walter K, Uhl M, Bley TA, Jüttner E, Brink I, et al. Imaging findings in a 3-year-old girl with type III pleuropulmonary blastoma. In Vivo 2007; 21(6):1119-22.
13.Khan AA, El-Borai AK, Alnoaiji M. Pleuropulmonary blastoma: a case report and review of the literature. Case Rep Pathol 2014; 2014:509086.
https://doi.org/10.1155/2014/509086
14.Nicol KK, Geisinger KR. The cytomorphology of pleuropulmonary blastoma. Arch Pathol Lab Med 2000; 124(3):416-8.
https://doi.org/10.5858/2000-124-0416-TCOPB.
15.Gelven PL, Hopkins MA, Green CA, Harley RA, Wilson MM. Fine-needle aspiration cytology of pleuropulmonary blastoma: case report and review of the literature. Diagn Cytopathol 1997; 16(4):336-40.
https://doi.org/10.1002/(sici)1097-0339(199704)16:4<336::aid-dc6>3.0.co;2-b
16.Drut R, Pollono D. Pleuropulmonary blastoma: diagnosis by fine-needle aspiration cytology: a case report. Diagn Cytopathol 1998; 19(4):303-5.
htts://doi.org/10.1002/(sici)1097-0339(199810)19:4<303::aid-dc16>3.0.co;2-r
17.Monaco SE, Teot LA, editors. Pediatric Cytopathology. Berlin, Heidelberg: Springer Berlin Heidelberg; 2017.
18.Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JHM, Beasley MB, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol 2015; 10(9):1243-60.
https://doi.org/10.1097/JTO.0000000000000630
19.Smyth RJ, Fabre A, Dodd JD, Bartosik W, Gallagher CG, McKone EF. Pulmonary blastoma: a case report and review of the literature. BMC Res Notes 2014; 7:294.
https://doi.org/10.1186/1756-0500-7-294
20.Vogels A, Fryns JP. Pfeiffer syndrome. Orphanet J Rare Dis 2006; 1:19.
https://doi.org/10.1186/1750-1172-1-19



DOI: https://doi.org/10.19106/JMedSci005403202209

Article Metrics

Abstract views : 916 | views : 828


Bookmark and Share


Copyright (c) 2022 Auliya Suluk Brilliant Sumpono, Alva Sinung Anindita, Junaedy Yunus, Didik Setyo Heriyanto

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.